[Management solutions using digital technologies in the Healthy Moscow pavilions].

The digital transformation of healthcare is an integral part of the priorities in modern healthcare. A striking example of the practical implementation of compliance with the basic principles of digital healthcare is the Healthy Moscow project, which has been implemented since 2021, which has become a real breakthrough in Russia in ensuring accessibility and convenience in providing medical care to the population. The aim of the project is the early prevention of chronic non-communicable diseases, the formation of a healthy lifestyle and the improvement of the well-being of Moscow residents, as well as the development of a conscious attitude to taking care of their health. Pavilions in the park areas of Moscow are an integral part of the modern medical infrastructure, providing convenient conditions for obtaining medical advice and information. The article provides information on the types of digital technologies and basic equipment that the pavilions (large and small) are equipped with as part of the Healthy Moscow project, it is shown that the introduction of digital healthcare technologies is one of the key tasks of the national strategy of Russia, which contributes significantly contribution to the successful implementation of the Healthy Moscow project.

[Some aspects of the organization and analysis of the performance of the orthodontic service in Ryazan and the Ryazan region]. / Nekotorye aspekty organizatsii i analiz pokazatelei ortodonticheskoi pomoshchi v Ryazani i Ryazanskoi oblasti.

OBJECTIVE: Conducting a retrospective analysis of the indicators of orthodontic care provided in Ryazan and the Ryazan region from 1999 to 2017. MATERIAL AND METHODS: During the study, institutions providing orthodontic care were divided into three levels of dental organizations. Level 1 medical care centers provide assistance to residents of districts of the region, the results of the work of clinics located in 2 districts of the region were analyzed for the period since 2005 to 2017. Level 2 StMO includes state dental clinics and private dental clinics in the city of Ryazan, where you can get orthodontic care. The work of state structures was analyzed from 1999 to 2011 with a step of 3 years, from 2011 to 2017. - yearly. Level 3 SMEs include specialized departments of universities, where only consultative and diagnostic assistance is provided. An analysis was made of the orthodontic pathology with which the patients treated, as well as an analysis of the orthodontic equipment used for treatment during the study period. RESULTS: The prevalence of AFA among the child population of the region's districts is at the level of 80.10±0.68%, fixed equipment is used 3 times more often in level 1 SMO than in level 2 SMI, and removable equipment is used only 10-20% less often. in the SMC and levels 1 and 2, the main part of the contingent is the child population (97.7-99.1% and 67.82-0.63%, respectively), but in the region for this type of assistance, the appealability among patients over 18 years of age is 10% less than in the city. CONCLUSION: The data obtained indicate the need for changes in the structure of orthodontic care. It is required to allocate at least 2 rates of an orthodontist in each district to provide assistance to the population living in the Ryazan region.

[The optimization of routing of patients with atherosclerosis of brachiocephalic arteries as exemplified by preventive examination in "Healthy Moscow" pavilions].

The article presents analysis of the program of preventive examinations of Moscow residents in the "Healthy Moscow" pavilions and the routing of patients with established atherosclerosis of brachiocephalic arteries. In 2022, within the framework of preventive examinations (check-ups) of Moscow residents in the "Healthy Moscow" pavilions, the pilot project of organization of surgical treatment of patients with established pathology of pre-cerebral arteries. The project included additional ultrasound examination of brachiocephalic arteries of males aged 45-72 years and females aged 54-72 years. the brachiocephalic artery stenosis was detected in 14 688 out of 370 416 people (4.0% of those passed the check-up). The stenosis was diagnosed in more than 50% - 1 369 people, 9.3% of all stenoses or 0.4% of those passed the check-up). At diagnosis of stenosis, more that 70% of patients were offered to undergo screening ultrasound examination at the "N. V. Sklifosovsky Research Institute of Emergency Care of the Moscow Health Department". The consultation was received by 117 patients out of 254 people. Out of them 22 patients were referred for additional examination, 70 patients for outpatient treatment, 25 patients for surgical treatment. The preventive examination of population organized in the "Healthy Moscow" pavilions permitted to identify sufficient number of patients requiring additional examination with following outpatient and/or surgical treatment of brachiocephalic artery stenosis who timely received necessary care. This result was facilitated by a number of organizational methodological measures implemented jointly with the Moscow Health Department".

[Assessment of patient satisfaction with orthodontic services provided in medical organizations of various forms of ownership]. / Otsenka udovletvorennosti patsientov ortodonticheskimi uslugami v meditsinskikh organizatsiyakh razlichnoi formy sobstvennosti.

OBJECTIVE: The study of expectations and satisfaction with the quality of orthodontic care provided to children in public and private dental organizations. MATERIAL AND METHODS: The study was conducted at the clinical bases of the Borovsky Institute of Dentistry of the Sechenov First Moscow State Medical University, Vladimirsky Moscow Regional Research Clinical Institute, Videntis LLC in the period from January to April 2022. An anonymous questionnaire was developed for the study: "Questionnaire for patients to assess the quality and conditions of orthodontic medical services in a medical organization". All data are processed using the statistical software SPSS v. 20. RESULTS AND DISCUSSION: According to respondents, the quality of service in both public and private dental organizations depends on the material and technical equipment of the medical organization, the attitude of medical personnel, the duration of treatment and the qualifications of orthodontists. Satisfaction of orthodontic care in public dental organizations corresponded to a high level in 73.4% of cases, an average level of 15.6% of cases, a low level in 11.0% of cases; in private dental organizations, a high level was noted in 98.8% of cases, an average level in 1.2% of cases, a low level in 0% of cases (in private dental organizations, not a single respondent noted the quality of services provided as low). Among the main reasons for dissatisfaction with the service of patients, the lack of diagnostic equipment, the unfriendly attitude of the secondary medical and administrative staff, as well as the duration of treatment should be highlighted. CONCLUSION: A sociological survey to assess patient satisfaction is a tool for determining the effectiveness of any medical organization, while the assessment of the quality of service of respondents depends on the material and technical equipment of the dental organization, the attitude of medical personnel, the duration of treatment and the qualifications of orthodontists. In this regard, it is very important to apply this method of satisfaction assessment when providing high-quality orthodontic care to children both in public and private dental organizations in order to improve the quality of service in a dental medical organization.

[Improvement of dental medical examination of patients of older age groups]. / Sovershenstvovanie stomatologicheskoi dispanserizatsii patsientov starshikh vozrastnykh grupp.

THE AIM OF THE STUDY: Was an improvement of dental health by optimizing dental medical examination in socially significant groups of the population. MATERIALS AND METHODS: A continuous sample of 500 patients aged 65 to 95 years who applied to selected private dental organizations and public dental organizations in the period 2017-2020 was made. The clinical study was carried out by taking an anamnesis and a dental examination. The results of a retrospective analysis of the prevalence and intensity of the main dental diseases in elderly and senile people are presented, a scheme for dental medical examination of the study group is proposed. RESULTS: In a comprehensive dental examination of groups of elderly and senile people, the DMFT in the age group of 65-74 years is 18.8 [14.35-24.4], in the group of 75-84 years 20.5 [13.7-27.3], while in people from the group over 85 years 24.9 [19.05-28] teeth, in order to reduce high dental morbidity we have developed an original scheme for the procedure for conducting preventive medical examinations of older age groups of the adult population. CONCLUSIONS: The results of the study indicate the insufficiency of preventive programs and therapeutic measures among the elderly and senile. The data obtained are aimed at substantiating the main directions for improving dental care for patients of the older age group in the current conditions of the healthcare system.

[Optimization of monitoring of pregnant women with various risk of dental caries relapse]. / Monitoring stomatologicheskogo statusa beremennykh s razlichnym riskom retsidiva kariesa zubov.

OBJECTIVE: The aim of the study is determination of the effectiveness of technologies for predicting the progressive course of dental caries in pregnant women. MATERIAL AND METODS: We examined 511 pregnant women aged 18-40 years with dental caries (304 were included in a main group, 207 were enrolled in controls), who were assessed the DMFT index sequentially in the 1st, 2nd and 3rd trimesters of pregnancy. The prognosis of recurrence of dental caries was determined by the method of two-stage clinical and laboratory prognosis. RESULTS: The prevalence of dental caries in the main group was 89.1% (271 out of 304 patients), in the control group - 87.9% (182 out of 207 patients). In the third trimester of pregnancy 36.2% of women in the main group had a recurrence of caries (vs 43.0% in the control group). Early examination of patients in the 1st trimester of pregnancy, followed by monitoring of the state of the organs and tissues of the mouth, made it possible to achieve timely treatment of dental caries and prevent its recurrence. In the third trimester of pregnancy, the DMFT-index in the dispensary group, in contrast to the control group, was statistically significantly (p<0.05) lower by 12.3%, which indicated the effective use of the proposed monitoring. CONCLUSION: The use of a system for providing dental treatment and preventive care in the form of screening, dynamic forecasting and assessment of the risk of recurrence of caries in pregnant women with dental caries and a high risk of its progression makes it possible to stop the development of this process and ensure the preservation of dental health.

[The disability of patients with amputation of upper and lower extremities in The Russian Federation].

The article presents characteristics of examined disabled patients with amputations of upper and lower extremities. The purpose of the study was to investigate demand of disability status in respondents (on gender, age, disability causes, amputation level, capability of moving in home conditions).

The study protocol: COVID-19 awareness and perception among dentists in the Russian Federation.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since it has been first identified in November 2018. It is transmissible via air droplets from infected individuals. Close contact between dentists and patients has aggravated the pandemic situation in Russia. It is necessary to reduce the risk of spreading COVID-19 during dental appointments by adhering to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations. SUBJECTS AND METHODS: Questionnaires were developed to assess levels of COVID-19 infection and preventive measures in private and state-funded dental practices in Moscow and other cities in Russia. Two questionnaires were developed to assess the COVID-19 situation among dental professionals and their patients. The first, for dentists, included four domains: demographic data, signs, and symptoms of COVID-19 experienced by dentists, personal protective measures taken by dentists, and presence or absence of dental practice during the pandemic. For dentists' patients, the second included domains regarding their health status after their dental appointment. 1,500 questionnaires were sent to different cities and regions of Russia; 1,011 questionnaires (67.4%) were returned. We used statistical observation (monitoring) and clustering to analyze the data. The x2 was used to check the significance level. RESULTS: We found a direct relationship between those patients who contracted COVID-19 after dental treatment by those dentists who did not follow recommended measures in the dental clinic. However, patients were less likely to become infected after dental treatment by those dentists who followed the measures, such as the disinfection of surfaces and dental equipment several times a day, the wearing of medical masks by all patients, and the airing of the dental office after each patient for 10 minutes. CONCLUSIONS: Dentists wearing an FFP2 or FFP3 respirator, as well as a sterile disposable microfiber medical gown, prevented their patients from becoming infected with COVID-19 at dental appointments and, as a result, the spread of the virus. A key aspect of this study is its knowledge regarding preventive measures against COVID-19. The findings of this study can potentially help in formulating strategies to reduce the prevalence of COVID-19.

[Medical-organizational and sociological characteristics of the staff of the dental service in a subsidiary subject of the Russian Federation]. / Mediko-organizatsionnaya i sotsiologicheskaya kharakteristika kadrovogo sostava stomatologicheskoi sluzhby dotatsionnogo sub"ekta Rossiiskoi Federatsii.

OBJECTIVE: To assess the working conditions of dentists in the Chechen Republic based on the results of a voluntary anonymous survey, to identify the shortcomings and problems in the functioning of the dental service that need to be corrected. MATERIAL AND METHODS: With the help of specially developed questionnaires, a voluntary anonymous survey of dentists providing primary medical and sanitary dental care in the Chechen Republic was conducted. The questionnaires included several blocks of questions, each of which pursued specific goals: first, to compose a social and professional «portrait¼ of a dentist; the second is to identify the opinions of respondents about the prevalence of dental pathology among the population, their attitude to the work of the dental service; the third is to identify certain shortcomings and problems that need to be corrected. RESULTS: The analysis of the respondents' answers received during the survey contributed to the compilation of an objective social and professional «portrait¼ of a dentist performing professional activities in the Chechen Republic, to study working conditions and satisfaction with them, legal regulation of activities, material support, the degree of professional training, to establish peculiarities of relationships with patients. Also indicated are the actual (according to dentists) problems of providing patients with medical dental care, shortcomings in the organization of the functioning of the dental service in the region. The issues of organizing preventive work, including the commitment of the population to maintaining their dental health and a number of other positions were studied. CONCLUSION: The method of voluntary anonymous questioning of dentists has shown its effectiveness, simplicity, convenience in assessing the state of dental care for the population, designating the range of characteristic specific problems that occur in a particular region (according to dentists), make it possible to establish what exactly is necessary to improve the quality provided medical care, and, therefore, allows you to outline ways to optimize activities.

[The influence of the degree of sanogenetic education of the population in a subsidized subject of the Russian Federation on dental health]. / Vliyanie stepeni sanogeneticheskoi podgotovki naseleniya v dotatsionnom sub"ekte Rossiiskoi Federatsii na sostoyanie stomatologicheskogo zdorov'ya.

OBJECTIVE: To determine the effect of healthy lifestyle (HLS) on dental health (prevalence and intensity of dental diseases). MATERIAL AND METHODS: The study was conducted in the standard age group 35-44 years. According to the results of a sociological survey, two groups were formed: leading HLS (1st group, 30 respondents) and those not leading HLS (2nd group, 34 respondents). The presence and prevalence of caries, its intensity (DMFT index), the hygienic state of the oral cavity (Green-Vermillion index (GRVI) and the effectiveness of oral hygiene (PHP), the state of periodontal tissues (CPITN)) were assessed. RESULTS: The prevalence of caries in group №1 was 77%, in 2nd group - 100%, the average value of the DMFT in group №1 was 8.9±0.2, in 2nd group - 17.1±0.3; the values of the GRVI index differed 5 times (1.1 and 5.2), the PHP index - 9 times (0.2 and 1.8, correspondently). In 2nd group, the high prevalence of dentition defects was revealed (40%), only 6% of patients had a normal periodontal condition, pathological periodontal pockets with a depth of 6 and more mm in patients were 3 times higher (9%) comparing to 1st group (3%). Periodontal care was required 94% of patients in the 2nd group (in 1st group - 72%). Patients in the 1st group took much better care of their teeth: the level of hygiene index was within 1.1 (in 2nd group - 5.2 - poor) Adequate oral hygiene regimen was found in 93% of patients in 1st group and only in 38% in 2nd group. CONCLUSIONS: The data obtained indicate not only poor dental health of the population, but also about significant shortcomings in the medical care and the low efficiency of preventive work on the part of the dental service.

[About quality of life of individuals disabled because of amputation in the Russian Federation].

The article presents characteristics of the factors affecting the quality of life of individuals with amputations of upper and lower limbs. The sources of the study were data of Rosstat, publications of Russian and foreign authors, the Federal Law "On social protection of disabled people in the Russian Federation", the UN Convention on the rights of disabled people and the State program of the Russian Federation "Accessible environment". On the basis of study results the actual characteristic of factors of quality of life of disabled amputees in the Russian Federation was presented.

[The structure of inflammatory periodontal diseases and the dynamics of the periodontal status in pregnant women during the gestational period]. / Struktura vospalitel'nykh zabolevanii parodonta i dinamika parodontal'nogo statusa beremennykh na protiazhenii gestatsionnogo perioda.

Basing on the analysis of 165 pregnant women with confirmed diagnosis of periodontal disease the structure of inflammatory periodontal diseases and periodontal status of pregnant women during gestation has been studied considering the influence of various factors on the dynamics of several periodontal and hygiene indices. The study proved a significant age-related deterioration of the periodontal status of pregnant women due to hormonal changes in the gestational period.

[Specific features of deployment of medical staff in the private dental sector]. / Osobennosti komplektovaniia vrachebnymi kadrami chastnogo stomatologicheskogo sektora.

The features of deployment of dentists of different specialties in the private dental sector of the city of Moscow are studied. On the material of 296 dentists, the main reasons for the employment, motivation to change from state, municipal, departmental to private medical organizations are considered for dentists of different specialties.

[Incidence and risk factors of oral diseases in pregnant women]. / Rasprostranennost' i faktory riska razvitiia osnovnykh stomatologicheskikh zabolevanii u beremennykh.

The prevalence of tooth caries and periodontitis in pregnant women has been studied; susceptibility of pregnant women to a high risk of development of dental pathology. Proven factors that modify the risk of tooth caries, periodontitis of mild and moderate severity in pregnancy are age over 30 years, repeated childbirth and pregnancy, complications of the gestational period, and for periodontitis, additionally - diseases of the digestive system, musculoskeletal system , anemia and metabolic-endocrine disorders.

[The Organization of Stomatological Care to Patients with Various Somatic Pathology].

The article considers actual national and international publications concerning problems of organization and characteristics of stomatological care support of patients with particular types of somatic pathology. The new approaches are analyzed concerning organization of efficient stomatological care of patients with various diseases.

[Quality of oral surgery and patients' satisfaction in state and municipal clinics]. / Kachestvo stomatologicheskoi khirurgicheskoi pomoshchi i udovletvorennost' eiu patsientov gosudarstvennykh i munitsipal'nykh poliklinik.

The aim of the multicenter study was to assess quality of oral surgical procedures and patients' satisfaction in state and municipal clinics in different regions of Russian Federation. A questionnaire survey was conducted in 3 regions of Russian Federation: European (Moscow, Tula, Tambov, Kaluga, Volgograd), North (Saint-Petersburg, Novgorod, Tver) and South (Armavir, Derbent, Kaspiysk, Kislovodsk, Makhachkala, Pyatigorsk, Rostov, Sochi, Stavropol). Sixty-six males and 34 females undergoing surgical dental treatment in public and municipal dental clinics (total number - 100 patients) at the age of 20 to 70 years (an average age was 36,3 and 39.5, respectively) were included in the study. Comparative analysis of patients' satisfaction rates in relation with expert evaluated quality of oral surgery is presented.

[Practical approach to the problem of additional vocational training of dentists]. / Poluchenie novoi (dopolnitel'noi) vrachebnoi spetsial'nosti rabotayushchimi vrachami-stomatologami: prakticheskaya realizatsiya poslediplomnogo obrazovaniya v svete sovremennykh pravovykh realii.

We consider the political and legal features and the possibility of operating a new medical specialty in the light of current legal requirements. The paper presents the review of the most pressing issues of modern law enforcement practices and features of the implementation of the rights and interests of the physician and the employer in terms of the search for a balance of interests and reasonable approach not contradicting to legal norms.

[Demographic Ageing in Russia at the Present Stage].

In the article data ofthe article describes thefindings of modern demographic indicators in Russia andforeign countriesfor the period 2010-2013. As a result of monitoring was defined Russia's status by demographics such as: proportion of population aged 60 years and older; total (men and women) life expectancy at birth; the rate of natural increase of population; mortality; fertility rate; the coefficient of migration growth and the dependency ratio. This article was presented analogy age-sex structure disclosed negative and positive aspects of the ageing of the population in Russia and foreign countries.

[Dental screening in patients with rheumatic disease].

Dental screening features of patients having rheumatic diseases are reviewed concerning such factors as examination and oral hygiene sessions frequency, specific rheumatic disease (rheumatoid arthritis, system lupus erythematosus and systemic sclerosis), oral and dental disorders (periodontal disease, dental caries, salivary glands disorders).

[The main aspects of the multidisciplinary dispensary dental care to elderly and senile population].

In the article presents the characteristics of the organization of dispensary work with patients older than 60 years. The main directions and objectives dispensary. The features of clinical supervision of dental patients belonging to the category of persons decreed by the elderly, senile age from the perspective of interaction professionals in a multidisciplinary clinic.